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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
631

Riesgo percibido en la construcción en España y Perú: un estudio exploratorio

Rodríguez Garzón, Ignacio, Castilla Rodríguez, Beatriz, Martínez Fiestas, Myriam, Universidad Peruana de Ciencias Aplicadas (UPC) 07 May 2015 (has links)
Introduction: The building sector is one of the most dangerous. It was measured the risk perception possessed by construction workers. Culture can affect risk perception. Objectives: Show the risk perceived by construction workers in Spain and Peru, compare and discuss the similarities and differences between countries. Materials and methods: An exploratory, cross sectional study. Two samples of workers were used: Spanish (N=204) and Peruvian (N=210), obtained in building works, civil works and training centers. The quantification method used is the psychometric paradigm and its adaptation to the Portell & Solé's occupational safety in the NPT of INSHT from Spain. Were used 9 qualitative attributes of risk and a global quantitative attribute. These attributes are measured by Likert scale from 1 to 7 points, while the global quantitative attribute is measured on a scale of 1 to 100. Results: Workers in environments with potential hazards or heavy machinery have a high perception of risk. Workers in both countries considered that have knowledge enough about safety at work. Spanish workers consider their health and safety managers do not have enough knowledge, being better rated in Peru. The probability of incident obtained low score. The global quantitative measure of risk did not obtain statistically significant difference between the two countries. Conclusions: perceived risk in construction should be studied to improve the health of their workers. / irgarzon@ugr.es / Introducción: El sector de la construcción es uno de los más peligrosos. Se midió la percepción del riesgo que poseen los trabajadores de la construcción. La cultura puede afectar la percepción del riesgo. Objetivos: Dar a conocer el riesgo que perciben los trabajadores de la construcción en España y Perú, comparar y discutir las similitudes y diferencias entre países. Materiales y métodos: Estudio de carácter exploratorio transversal. Se utilizaron dos muestras de trabajadores: Españoles (N=204) y Peruanos (N=210) obtenidas en obras de edificación, obras civiles y centros de formación. El método de cuantificación es el paradigma psicométrico y su adaptación a la seguridad ocupacional de Portell & Solé en la NTP 578 del INSHT de España. Se utilizaron 9 atributos cualitativos del riesgo y un atributo cuantitativo global. Estos atributos se miden mediante escalas Likert de 1 a 7 puntos, mientras que el atributo cuantitativo global se mide mediante una escala de 1 a 100. Resultados: Los trabajadores de ambientes con riesgos potenciales o con maquinaria pesada tienen una percepción alta del riesgo. Los trabajadores de ambos países consideran que poseen suficiente conocimiento sobre la seguridad en el trabajo. Los trabajadores españoles consideran que sus responsables de seguridad y salud no poseen suficiente conocimiento, siendo mejor puntuados en Perú. La probabilidad de ocurrencia obtuvo baja puntuación. La medida cuantitativa global del riesgo no obtuvo diferencia estadísticamente significativa entre ambos países. Conclusiones: se debe estudiar el riesgo percibido en la construcción para mejorar las condiciones de salud de sus trabajadores.
632

El riesgo percibido y la gestión de la seguridad

Rodríguez Garzón, Ignacio, Martínez Fiestas, Myriam, López Cuellar, Álvaro, Universidad Peruana de Ciencias Aplicadas (UPC) 18 August 2015 (has links)
Introduction: Firefighters are workers who usually live with risks inherent with their profession. Objectives: To delve about the concept of perceived risk as a tool for managing occupational risk. Materials and methods: The model used for risk quantification was the psychometric paradigm. Thus, anonymous surveys were conducted at different fire stations. The questionnaire contained demographic questions, nine questions on various attributes of risk and a question about risk perception of the subject in general. Results: Statistical analysis showed two distinct groups in terms of their perception of risk. The first group is represented by members with a high perception of risk and the second one with low risk perception. Finally, it is showed that educational level was only a significant variable for perceived risk explaining. Conclusions: Results are discussed in terms of existing literature concluding that training workers is necessary to raise their perception of risk. / Introducción: El personal de emergencia convive habitualmente con riesgos inherentes a su profesión. Objetivos: Profundizar acerca del concepto del riesgo percibido como herramienta para gestionar el riesgo ocupacional. Materiales y métodos: El modelo utilizado para la cuantificación del riesgo ha sido el paradigma psicométrico. De esta forma, se realizaron encuestas anónimas en las diferentes estaciones de bomberos. El cuestionario contenía preguntas sociodemográficas, nueve preguntas acerca de distintos atributos del riesgo y una pregunta acerca de la percepción del riesgo en general del sujeto. Resultados: El análisis estadístico muestra dos grupos claramente diferenciados en cuanto a su percepción del riesgo, siendo uno de ellos caracterizado por tener sus integrantes una alta percepción del riesgo y el otro por tener una baja percepción del riesgo. Por último, se muestra que solamente el nivel educacional era una variable significativa en la explicación del riesgo percibido. Conclusiones: Los resultados son discutidos en función de la literatura existente concluyendo que se debe formar a los trabajadores para elevar su percepción del riesgo.
633

The Effect of Psychometric Parallelism among Predictors on the Efficiency of Equal Weights and Least Squares Weights in Multiple Regression

Zhang, Desheng 05 1900 (has links)
There are several conditions for applying equal weights as an alternative to least squares weights. Psychometric parallelism, one of the conditions, has been suggested as a necessary and sufficient condition for equal-weights aggregation. The purpose of this study is to investigate the effect of psychometric parallelism among predictors on the efficiency of equal weights and least squares weights. Target correlation matrices with 10,000 cases were simulated so that the matrices had varying degrees of psychometric parallelism. Five hundred samples with six ratios of observation to predictor = 5/1, 10/1, 20/1, 30/1, 40/1, and 50/1 were drawn from each population. The efficiency is interpreted as the accuracy and the predictive power estimated by the weighting methods. The accuracy is defined by the deviation between the population R² and the sample R² . The predictive power is referred to as the population cross-validated R² and the population mean square error of prediction. The findings indicate there is no statistically significant relationship between the level of psychometric parallelism and the accuracy of least squares weights. In contrast, the correlation between the level of psychometric parallelism and the accuracy of equal weights is significantly negative. Under different conditions, the minimum p value of χ² for testing psychometric parallelism among predictors is also different in order to prove equal weights more powerful than least squares weights. The higher the number of predictors is, the higher the minimum p value. The higher the ratio of observation to predictor is, the higher the minimum p value. The higher the magnitude of intercorrelations among predictors is, the lower the minimum p value. This study demonstrates that the most frequently used levels of significance, 0.05 and 0.01, are no longer the only p values for testing the null hypotheses of psychometric parallelism among predictors when replacing least squares weights with equal weights.
634

Multi-dimensionele vlugtaksering

14 October 2015 (has links)
D.Litt. et Phil. / In recent times the South African society has been subject to rapid and important changes. These changes resulted in new responsibilities placed on social workers and psychologists. This situation has lead to the development of new perspectives and the expansion of knowledge and understanding. Social workers and psychologists are increasingly under pressure to provide cost effective services to an increasing number of clients without reducing accountability. Counsellors have to be able to support their decisions with scientific evidence ...
635

Diversifying psychometric tools for intelligence assessment and screening in Latin America

Duggan, Emily C. 15 July 2019 (has links)
Objective: Cultural neuropsychologists face barriers such as access to culturally appropriate psychometric instruments and norms. Further, three commonly encountered dilemmas in cultural neuropsychology include the following questions: (1) How do psychologists determine the best normative data to use for a given assessment scenario? (2) Do measures and models developed with North American samples also work in adaptations of instruments used with cross-cultural samples? (3) How can alternative and cost-effective measures be developed to meet the need for additional assessment tools? In response to these dilemmas, this dissertation consists of three papers aimed at developing Latinx and cultural neuropsychology psychometric resources for one of the most common cultural assessment scenarios: intelligence assessment amongst Spanish-speaking individuals using the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV). Chapter 1. A sample of 305 highly educated Colombian corporate executives completed the WAIS-IV. Data were scored using norms from Colombia, Chile, Mexico, Spain, United States, and Canada and scores were compared using ANOVA. Additionally, a comparative sociodemographic framework was established to contextualize our sample to the standardization samples and populations of the six countries. Chapter 2. Accumulating evidence indicates the original factor structures published in the Wechsler Intelligence Scales may not best describe the data captured by these tests, and instead supports a five factor Cattell-Horn-Carroll (CHC) model over a four factor Wechsler model, and a bifactor model over a higher-order model. Confirmatory factor analysis and structural equation modeling was used to evaluate factor structure of the Chilean-WAIS-IV (Wechsler, 2013) normative sample (ages 18-60; N=672) to better understand its psychometrics and to contribute to much needed cross-cultural study of alternative WAIS-IV factor models. Results marginally favored CHC and bifactor models but provided strong support for higher-order and Wechsler model variants as well, pointing to the need of further theoretical, methodological, clinical, and cross-cultural research. Chapter 3. The recent publication of the Chilean adaptation of the WAIS-IV has contributed to ongoing efforts to provide more psychometric instruments culturally appropriate for regions in South America. While not all assessment situations necessitate administration of the full WAIS and calculation of a full-scale intelligence quotient (FSIQ), there is virtually no published research on WAIS-IV short forms for estimating IQ in Latin America. This study used a rigorous series of methods (adapted from Smith et al., 2000) to develop robust estimated IQ short forms, aligned with Wechsler and CHC models, using the Chilean WAIS-IV standardization data (ages 18-90; N=887). Linear scaling was used to produce normative tables for the 28 best two-, three-, four-, and five subtest short forms of the Chilean WAIS-IV. Discussion. Together, the three papers of this dissertation provide psychometric guidance and resources not only for Latin American neuropsychologists in the area of intelligence assessment, but also more broadly for all cultural neuropsychology researchers and clinicians. / Graduate / 2020-06-25
636

Adaptação cultural e evidências de validade do demands of illness inventory patient e partner version, em pacientes com câncer e cônjuges / Cultural adaptation and evidence of validity of the Demands of Illness Inventory-patient and partner version, in cancer patients and spouses

Benavente, Sonia Betzabeth Ticona 30 August 2017 (has links)
Introdução: o câncer não afeta unicamente o paciente, mas também o cônjuge. Assim, torna- se necessário identificar as demandas oriundas da doença e o tratamento, a fim de ter uma visão completa do paciente e cônjuge para aprimorar a assistência clínica e facilitar às equipes a tomada de decisão para a realização de cuidados. Ao perceber a falta de instrumentos em português brasileiro que pudessem identificar essas demandas, foi escolhido o Demands of Illness Inventory (DOII) Patient Version e Partner Version, que se caracteriza por abordar de forma abrangente as demandas, preocupações e necessidades dos pacientes com câncer e cônjuges. Objetivo: adaptar culturalmente e avaliar as propriedades psicométricas dos instrumentos DOII, na versão do paciente e esposo, em pacientes portadores de câncer e cônjuges, para o português brasileiro. Método: estudo metodológico desenvolvido em duas etapas, a adaptação cultural e a avaliação psicométrica dos instrumentos. A adaptação cultural foi a preconizada por Beaton et al. As propriedades psicométricas da versão do paciente foram avaliadas em 658 pacientes com câncer em tratamento quimioterápico de um hospital público de grande porte de São Paulo. Já a versão do esposo foi realizada em 170 esposos de pacientes da mesma instituição. Para a validade de conteúdo utilizaram-se o IVC (Indice de Validade de Conteúdo) e o coeficiente Kappa. Para a validade de construto foi realizada a Análise Fatorial Exploratória (AFE). Para a validade convergente e divergente foi utilizada a análise de correlação, na versão do paciente foi aplicado o Termômetro de Distress e o instrumento que avalia a qualidade de vida EORTC-CQC-30, respectivamente; na versão do esposo foi aplicada a Escala de Estresse Percebido (PSS-14) e o Inventário de estratégias de Coping de Folkman e Lazarus. A confiabilidade foi testada pelos coeficientes alfa de Cronbach e ômega de McDonald. Resultados: todas as etapas de adaptação cultural foram realizadas satisfatoriamente de ambas versões adaptadas. Para a validade de conteúdo, o IVC e Kappa apresentaram valores superiores a 0,75 e 0,72 respectivamente, para a maioria dos itens. Para a validade de construto, obteve-se medidas de KMO (Kaiser-Meyer-Olkin)=0,930 e 2 de Bartlett = (8256) 47209,9; p < 0,001. A AFE mediante a análise paralela foram retidos 11 fatores que explicam 46,5% da variância total do fenômeno de estudo. A confiabilidade para a escala total foi de 0,961 para o alfa de Cronbach e 0,952 para ômega de McDonald. Na versão do esposo, a validade de construto obteve indicadores de KMO= 0,818 e 2 de Bartlett= (528) 2414,1, p < 0,001. De acordo com a análise paralela 4 fatores foram retidos que explica 52,9% da variância total do fenômeno de estudo. A confiabilidade para a escala total foi de 0,894 para o alfa de Cronbach e 0,876 para ômega de McDonald. Na versão do paciente, as correlações das validades convergente e divergente foram r=0,605 (p<0,01) e r=0,660 (p<0,01), respectivamente. Na versão do cônjuge, foram r=0,334, p0,01 e r=0,260, p0,01, respectivamente. Conclusões: o DOII, na versão do paciente e esposo, mostrou-se adaptado culturalmente a pacientes com doenças crônicas como o câncer no contexto brasileiro e aos cônjuges, apresentando evidências de validade de conteúdo, construto e confiabilidade. Recomenda-se realizar a Análise Fatorial Confirmatória. / Introduction: cancer affects not only the patient, but also the spouse. Thus, it becomes necessary to identify the demands arising from the disease and the treatment, in order to have a complete view of the patient and spouse to improve clinical care and facilitate the decision- making of the healthcare teams. By observing the lack of instruments in Brazilian Portuguese that could identify these demands, the Demands of Illness Inventory (DOII) - Patient Version and Partner Version has been chosen, which is characterized by comprehensively addressing the demands, concerns and needs of cancer patients and spouses. Objective: to culturally adapt and to evaluate the psychometric properties of the DOII instruments, in the patient and in the spouses version; in patients with cancer and their spouses, in Brazilian Portuguese. Method: A methodological study developed in two stages, the cultural adaptation and the psychometric evaluation of the instruments. The cultural adaptation has been advocated by Beaton et al. The psychometric properties of the patient\'s version have been evaluated in 658 cancer patients in chemotherapy treatment of a large public hospital in São Paulo. The spouse\'s version has been used in 170 spouses of patients from the same institution. For the content validity, the CVI (Content Validity Index) and the Kappa coefficient have been used. For the construct validity, the Exploratory Factor Analysis (EFA) has been performed. For the convergent and divergent validity, the correlation analysis has been performed in the patient\'s version with the Distress Thermometer and the EORTC-CQC-30 instrument, respectively; in the spouse\'s version, with the Perceived Stress Scale (PSS-14) and the Folkman and Lazarus Coping Inventory, respectively. Reliability has been tested by Cronbach\'s alpha and McDonald\'s omega coefficients. Results: all the stages of cultural adaptation have been satisfactorily performed in both adapted versions. For the content validity, IVC and Kappa have presented values higher than 0.75 and 0.72, respectively, for most items. For the construct validity, the following KMO (Kaiser-Meyer-Olkin) measurements have been obtained= 0.930 and Bartlett\'s 2= (8256) 47209.9; p <0.001. The EFA, through the parallel analysis, has comprised the 11 retained factors that account for 46.5% of the total variance. The reliability for the full scale was 0.961 for Cronbach\'s alpha and 0.952 for McDonald\'s omega. In the spouse\'s version, the construct validity has obtained indicators of KMO= 0.818 and 2 of Bartlett= (528) 2414.1, p <0.001. According to the parallel analysis, has comprised the 4 retained factors that account for 52.9% of the total variance. The reliability for the full scale was 0.894 for Cronbach\'s alpha and 0.876 for McDonald\'s omega. In the patient\'s version, the convergent and divergent validity correlations were r= 0.605 (p <0.01) and r= - 0.660 (p <0.01), respectively. In the spouse\'s version, they were r= 0.334, p0.01 and r= 0.260, p0.01, respectively. Conclusions: The DOII, in the patient and in the spouse\'s version, has been culturally adapted to patients with chronic diseases such as cancer in the Brazilian context and to the spouses, presenting evidence of content validity, construct and reliability. It is recommended to perform the Factorial Confirmatory Analysis.
637

"Alterações de humor associadas a atividade física intensa" / Mood alterations associated with intense physical activity

Peluso, Marco Aurélio Monteiro 08 May 2003 (has links)
A atividade física é considerada uma prática que traz benefícios para o corpo e a mente. Entretanto, se por um lado há evidências de que exercício físico moderado pode ajudar a saúde mental, também existem relatos de alterações de humor com características depressivas associadas ao treinamento de atletas de elite, podendo culminar com o aparecimento da chamada “síndrome de overtraining". Este trabalho procurou avaliar estas alterações de humor associadas a atividade física intensa, focando-se em três pontos: 1) caracterização de suas manifestações psicológicas, 2) avaliação da especificidade da associação e 3) verificação da possibilidade de alguma vulnerabilidade constitucional influenciar as alterações. Os sujeitos se dividiram em três grupos: atletas (N = 56, 30 homens – 26 mulheres; idade média = 18,16 anos), vestibulandos (222, 120 – 102; 17,48) e universitários (446, 259 – 187; 22,08). Instrumentos de avaliação de humor (POMS e PANAS-X) foram aplicados em atletas e vestibulandos em três oportunidades, ao longo da preparação para a competição mais importante da temporada ou o vestibular. Universitários, submetidos a estresse físico e intelectual estável e relativamente menor, foram avaliados apenas uma vez. Foram estudadas as variações de estados afetivos de cada grupo e suas relações com a quantidade de treinamento / estudo e a proximidade da competição / vestibular. O grupo de atletas e uma amostra de vestibulandos, definida randomicamente, foram avaliados com um instrumento de diagnóstico psiquiátrico (SCAN). Foi estudado, utilizando-se sintomatologia psiquiátrica prévia ou “afeto negativo traço" como marcadores, se fatores de vulnerabilidade exerceram algum tipo de influência sobre as alterações de humor em estudo. Os resultados foram avaliados segundo os três grupos de sintomas de um modelo tripartide de ansiedade e depressão: 1) um fator geral de afeto negativo, que inclui sintomas não específicos; 2) um grupo de sintomas relativamente específicos de depressão, o qual reflete falta de experiências emocionais positivas (chamado de afeto positivo), e 3) um grupo de sintomas relativamente específicos de ansiedade, o qual reflete manifestações de tensão somática. Foram encontradas alterações de humor entre os atletas. Suas características principais foram: aumento de fadiga, diminuição de afeto positivo e nenhuma alteração de afeto negativo (o que indica proximidade com o construto de depressão); associação com a quantidade e a intensidade de treinamento, mas não com a proximidade da competição; nenhuma influência de fatores de vulnerabilidade. Os vestibulandos também apresentaram alterações de humor, mas com características diferentes: aumento de fadiga, aumento do afeto negativo e nenhuma alteração do afeto positivo (o que indica proximidade com o construto de ansiedade); associação com a proximidade do vestibular (a associação com a quantidade de estudo não foi conclusiva); tendência de que fatores de vulnerabilidade ligados a sintomatologia psiquiátrica prévia influenciem sua intensidade. Esses resultados apontam para a especificidade da associação entre as alterações de humor encontradas entre os atletas e a atividade física intensa a qual se submetem. / Physical activity is considered to be beneficial to both body and mind and evidences that moderate intensity exercise can improve mental health are increasing. Nevertheless, there are also evidences that depressive mood alterations are associated with elite athletes training and that this training can lead to the so called “overtraining syndrome". This work aimed to evaluate these mood alterations associated with intense physical activity considering three points: 1) characterization of its psychological manifestations, 2) association specificity, and 3) influence of some kind of constitutional vulnerability. Subjects were athletes (N = 56, 30 men – 26 women; mean age = 18,16 years), last year high school students (222, 120 – 102; 17,48) and college students (446, 259 – 187; 22,08). Athletes and high school students were evaluated with psychometric instruments (POMS and PANAS-X) three times during the preparation for the most important competition of the season or for the “vestibular" (Brazilian exam to enter college). College students, submitted to stable and relatively lower levels of physical and intellectual demands, were evaluated only once. Mood states fluctuations and their relation to training volume / hours of study and proximity to competition / “vestibular" were studied. The athletes and part of the high school students, randomly selected, were also evaluated with a psychiatric diagnostic instrument (SCAN). The influence of vulnerability factors over the mood alterations were studied, using previous psychiatric symptomatology or negative affect trait as markers. Results were evaluated according to the three groups of symptoms from a tripartite model of anxiety and depression: 1) a general negative affect factor, which includes nonspecific symptoms; 2) a relatively specific depression cluster of symptoms that reflects the absence of positive emotional experiences (called positive affect); and 3) a relatively specific anxiety cluster of symptoms that reflects the manifestations of somatic tension. Mood alterations were found among the athletes. Presence of fatigue, diminished positive affect and no alteration in negative affect (which points to proximity to the depression construct); association with training volume and intensity, but not with competition proximity; and no vulnerability factors (related to psychiatric history, trait negative affect and profile of affective traits) influence were the athlete mood alterations characteristics. The high school students showed mood alterations too, but with different characteristics: fatigue, increased negative affect and no alteration in positive affect (which points to proximity to the anxiety construct); association with “vestibular" proximity (the association with study volume was non conclusive); and a tendency that vulnerability factors (related to psychiatric history) influences their intensity. Results point to the specificity of the association between the athletes’ mood alterations and the intense physical activity performed by them.
638

Adaptação cultural e validação do herth hope index para a lingua portuguesa: estudo em pacientes com doença crônica / Cultural adaptation and validation of the herth hope index for portuguese language: study in patients with chronic illness

Sartore, Alessandra Cristina 16 March 2007 (has links)
O enfrentamento do processo do adoecer é mais adequado quando os pacientes possuem esperança. É a esperança na recuperação da saúde que leva o paciente a enfrentar todas as adversidades decorrentes do adoecimento e do tratamento. A avaliação da esperança proporciona a implementação de intervenções que estimulam esperança em pacientes em cuidados paliativos e seus familiares. Diante da inexistência de um instrumento validado no Brasil para medir esse construto, optou-se pela realização da adaptação e validação do Herth Hope Index. Era também nossa intenção comparar o sentimento de esperança entre pessoas sadias, doentes com câncer e de doentes com outra doença crônica com características diferentes, como o diabetes. O estudo teve como objetivos fazer a adaptação cultural e a validação do instrumento Herth Hope Index, comparar os escores de esperança entre pacientes oncológicos, diabéticos e acompanhantes, analisar as relações entre o nível de esperança da amostra com as variáveis sócio-demográficas e analisar as relações entre o nível de esperança nos dois grupos de pacientes com variáveis clínicas de interesse. A adaptação cultural e validação do Hert Hope Index foram realizadas conforme o método preconizado pela literatura. A amostra foi composta por 131 indivíduos, divididos em 3 grupos. Os resultados obtidos demonstram que em relação às propriedades psicométricas, o instrumento apresentou um valor de alpha de Cronbach de 0.834 para a escala total. O teste-reteste conferiu a reprodutibilidade do instrumento. A validade de construto foi confirmada por meio da validade convergente que demonstrou correlação estatisticamente significativa entre a Escala de Esperança de Herth (denominação da versão brasileira) e a Escala de Auto-Estima de Rosenberg, e da validade divergente que também evidenciou correlação significante entre a Escala de Esperança de Herth e o Inventário de Depressão de Beck. A análise fatorial pelo método dos componentes principais não confirmou os três fatores da escala original confirmou apenas que existem três fatores, mas com composição diferente dos itens em relação à escala original. O nível de esperança nos três grupos foi elevado e não houve diferença estatística entre eles. A comparação entre o nível de esperança e as variáveis sócio-demográficas na amostra estudada não apresentou diferença estatisticamente significativa. O nível de esperança não foi relacionado com a dor e tipo de tumor nos pacientes oncológicos e nem com o tratamento ou coexistência de hipertensão arterial nos diabéticos. As propriedades psicométricas do instrumento foram demonstradas e, portanto ele pode ser utilizado para mensurar a esperança na população brasileira. Considera-se importante que a Escala de Esperança de Herth continue a ser testada quanto à sua confiabilidade e validade em diferentes contextos sócio-culturais da realidade brasileira / Facing the process of being sick is more properly done when patients have hope.It\'s the hope of recovering that makes the patient able to face all the difficulties caused by the disease and its treatment. The evaluation of hope makes possible to implement actions which stimulate hope in patients under palliative care and the people who take care of them, specially their relatives. Once in Brazil there is no validated instrument for measure this, the option was to adapt and validate the Herth Hope Index. Our intention was also to compare the feeling of hope of healthy persons, cancer patients and patients with other kinds of chronic disease, with different features, such as diabetes.This study aimed the cultural adaptation and validation of the Herth Hope Index, to compare the hope scores of oncology and diabetic patients and their family, to analyze the relation between their level of hope and social-demographic factors, and to analyze the relation between the level of hope of these two groups of patients and the relevant clinical variables.Cultural adaptation and validation of the Herth Hope Index were done according to the methods already described in literature. There were 131 patients, divided into 3 groups. The result shows that, concerning to psychometric properties, this instrument has presented alpha coefficient of 0.834 for total scale. The test-retest awarded the reliability of the instrument. The construct validity was confirmed by means of the convergent validity that significant correlation between Herth Hope Index (Brazilian version) demonstrated significant correlation with Rosenberg’s Self Steem Scale, and the divergent validity that also significant correlation between Herth Hope Index and the Beck Depression Inventory. The factorial analyses, by the main components method, has not confirmed the three factors of the original scale. It has confirmed only that there are three factors, but there is a different composition among the items of the original scale. The level of hope in these three groups was elevated and there was no statistical difference among them. Comparison between the level of hope and the social-demographical variables hasn\'t shown any statistically significant differences. The level of hope hasn\'t been related to pain and kind of tumor in oncology patients neither to treatment or coexistence of arterial hypertension in diabetic patients either. The psychometrics properties of this tool were demonstrated, it can be used in the evaluation of hope of the Brazilian people. It\'s important that the Herth Hope Index keeps been tested, specially regarding it\'s reliability and validity in different socio-cultural aspects of the Brazilian context
639

Validação de escala para rastreamento de depressão em idosos: importância de um teste de aplicação rápida / Validation of a depression screening scale for the elderly: importance of a quick application test

Barczak, Daniel Sindelar 27 February 2012 (has links)
INTRODUÇÃO: Os critérios diagnósticos atuais para as síndromes depressivas não identificam uma parcela dos idosos com sintomatologia depressiva clinicamente significativa. Instrumentos psicométricos específicos para esta população, que sejam rápidos e fáceis de aplicar tornam-se necessários. A partir de instrumentos previamente validados como as escalas GDS e CES-D, e de um consenso de especialistas foi desenvolvida uma escala de 10 itens para avaliar o construto clínico de depressão em pacientes idosos. OBJETIVO: Validação interna de uma nova escala de rastreio de sintomas depressivos em idosos (D10) desenvolvida no Programa Terceira Idade (PROTER), Instituto de Psiquiatria HC FMUSP. MÉTODOS: Uma amostra de conveniência composta por 62 sujeitos foi utilizada para o estudo de validade de critério (validade concorrente). Destes, 44 foram incluídos nos estudos de confiabilidade (consistência interna, estabilidade e equivalência) e de validade de construto (validades convergente e divergente). Todos os participantes incluídos tinham idade 60 anos, não apresentavam doenças médicas graves ou descompensadas, déficits cognitivo e funcional significativos (avaliados, respectivamente, pela M-CIRS, MMSE e B-ADL) e não apresentavam histórico passado ou atual sugestivo de síndrome psicótica. Os diagnósticos foram obtidos pela entrevista estruturada MINI-Plus (seções A, B, D, E, F e P) e a intensidade dos sintomas depressivos mensurados pela MADRS. Outros instrumentos foram utilizados (CAMCOG, IQCODE, CAGE, DUSI-R) no desenho da pesquisa, para reduzir a possibilidade de vieses sistemáticos. A distribuição da amostra foi avaliada pelo Teste Kolgomorov-Smirnov, e os índices de correlação de Pearson e Spearman foram utilizados para aferir a relação entre a D10 e as escalas MADRS e CAGE. A correlação entre os itens da D10 foram analisados pelos coeficientes de Correlação Intraclasse (CCI) e alfa de Cronbach. A acurácia do teste foi investigada pela análise das áreas sob as curvas ROC. RESULTADOS: A amostra (idade média de 72,35; SD=7,05) não apresentou diferenças significativas entre as variáveis sócio-demográficas, econômicas, clínicas, cognitivas e funcionais estudadas (p>0,05). O valor de alfa (consistência interna) manteve-se estável e elevado (=0,84±0,02) e os itens da D10 apresentaram boa equivalência (inter-rater) (rs=0,95, p0,01) e boa estabilidade (intra-rater) (rs=0,95, p0,01). A escala MADRS correlacionou-se significativamente com a D10 (rp=0,86, e rs=081, p0,01), não tendo se correlacionado com a CAGE (p>0,05). Esse achado foi reforçado pela correlação entre a CAGE e a DUSI-R (rp=0,31, p=0,005; e rs=0,29 p=0,01). A nota de corte de 6 pontos na D10 apresentou elevados níveis de sensibilidade (96,2%), especificidade (88,9%), valor preditivo positivo (86,2%), valor preditivo negativo (97%) e acurácia (91,9%). O tempo médio de aplicação do novo instrumento foi de 42±4 segundos. CONCLUSÕES: Os resultados obtidos indicaram que a escala D10 apresentou confiabilidade, validade interna, e acurácia adequadas para ser utilizada como um instrumento de aplicação rápida para o rastreio de sintomatologia depressiva clinicamente significativa em idosos / identify a portion of elderly people with clinically significant depressive symptoms. Specific psychometric instruments for this population with quick and easy application properties are of the essence. Based on previously validated instruments, such as GDS and CES-D scales, and on consensus among specialists, a 10-item scale was developed to assess the clinical depression construct in elderly patients. OBJECTIVES: Internal validation of a scale to screen depressive symptoms in elderly people (D10) developed in the Senior Citizens Program (locally, PROTER), at the Institute of Psychiatry of the HCFMUSP. METHODS: A convenience sample of 62 subjects was used for the criterion validity study (concurrent validity). Of these, 44 were included in the studies of reliability (internal consistency, stability and equivalence) and of the construct validity (convergent and divergent validity). All the participants included in the study were 60 years old, did not present any serious or uncontrolled medical conditions, significant cognitive or functional deficits (evaluated, respectively, through M-CIRS, MMSE and B-ADL), nor past or present history suggestive of psychotic syndrome. Diagnostics were obtained through the MINI-Plus structured interview (sections A, B, D, E, F and P), and the intensity of depressive symptoms through the MADRS. In the research design, other instruments were used (CAMCOG, IQCODE, CAGE, DUSI-R), aimed at reducing the possibility of systematic bias. The sample distribution was evaluated through the Kolgomorov- Smirnov Test, and the Pearson and Spearman correlation indexes were used to verify the relation between the D10 and the MADRS and CAGE scales. The correlation of the D10 items were analyzed through the Intraclass Correlation (ICC) and Cronbach\'s alpha. The test accuracy was investigated through the analysis of the areas under ROC curves. RESULTS: The sample (mean age of 72,35; SD=7,05) did not evidence significant differences in the socio-demographic, economic, clinical, cognitive and functional variables studied (p>0,05). The alpha value (internal consistency) remained stable and elevated (=0,84±0,02), D10 items presented good equivalence (inter-rater) (rs=0,95, p0,01) and good stability (intra-rater) (rs=0,95 p0,01). The MADRS scale correlated significantly with CAGE (p>0,05). This finding was reinforced by the correlation between CAGE and DUSI-R (rp=0,31 p=0,005; and rs=0,29 p=0,01). A cut-off score of 6 points in D10 presented high levels of sensitivity (96,2%), specificity (88,9%), positive predictive value (86,2%), negative predictive value (97%) and accuracy (91,9%). The average application time of the new instrument was 42±4 seconds. CONCLUSIONS: The results obtained indicate that the D10 scale presented adequate reliability, internal validity and accuracy for use as a quick application instrument to screen clinically significant depressive symptoms in the elderly
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Propriedades psicométricas da versão brasileira do questionário Quality of recovery - 40 item / Psychometric properties of the Brazilian version of the questionnaire Quality of recovery - 40 item

Eduardo, Aline Helena Appoloni 04 August 2015 (has links)
A recuperação cirúrgica é um evento complexo que abarca a retomada de atividades do cotidiano e melhora do estado físico, psicológico e emocional dos pacientes que foram alteradas em consequência do tratamento cirúrgico. Contudo, a determinação do momento em que a recuperação da cirurgia ocorreu requer rigoroso acompanhamento dos pacientes. O questionário Quality of recovery -40item (QoR-40), por permitir a avalição da recuperação cirúrgica compreendendo dimensões físicas, psicológicas, emocionais e sociais, pode ser uma importante ferramenta para este acompanhamento. O QoR-40 possui 40 itens com escala Likert de resposta e o escore total varia de 40 a 200, sendo que quanto maior o resultado melhor o recuperação cirúrgica. Trata-se de um estudo metodológico que teve como objetivo principal validar, para o uso entre pacientes submetidos a prostatectomia radical, a versão brasileira do questionário QoR-40. O questionário foi aplicado em uma amostra de 200 pacientes prostatectomizados radicais em quatro momentos: pré e pós-operatório, primeiro e segundo retornos. Realizou-se análise semântica dos itens do questionário, em uma amostra independente a da validação, para investigar a compreensão e relevância de cada item. Para a validade de constructo convergente foi investigada a correlação de Pearson entre a medida do QoR-40 e as medidas dos constructos relacionados aos domínios do questionário de qualidade de vida (SF-36v2®) e com a medida da escala visual analógica de recuperação cirúrgica (VAS recuperação cirúrgica). A validade discriminante foi investigada por meio de grupos conhecidos, pelo teste Mann-Whitney, considerando a medida do QoR-40 nos grupos de pacientes com o diagnóstico de enfermagem Recuperação cirúrgica retardada, com incontinência urinária e disfunção erétil. A fidedignidade foi investigada por meio da consistência interna, considerando o alfa de Cronbach e correlações inter-item e item-total. A responsividade foi investigada por meio de regressão linear com efeitos mistos e análise da média de respostas padronizadas (SRM). A análise semântica, realizada com 24 sujeitos, resultou em discretas alterações na redação nos itens 6, 19 e 23 de maneira que atendeu a compreensão dos sujeitos, conforme identificado no pré-teste. Na validade de constructo convergente, as correlações entre as medidas do QoR-40 e as medidas dos domínios do SF- 36v2® e da VAS recuperação cirúrgica foram predominantemente moderadas (r=0,18 a 0,89); a validade de constructo discriminante constatou diferenças entre pacientes com o diagnóstico de enfermagem Recuperação cirúrgica retardada e com incontinência urinária (p<0,01). A fidedignidade, por meio da consistência interna, obteve valeres de alfa de Cronbach satisfatórios (0,75 a 0,86) e correlações inter-item e item-total predominantemente moderadas (r=0,02 a 0,64). A responsividade foi adequada com média de diferença das medidas estatisticamente significantes (p<0,01) no decorrer do tempo e com SRM variando de 0,03 a 1,11. Conclui-se que o QoR-40 possui adequada validade, fidedignidade e responsividade a partir dos dados obtidos no estudo realizado entre sujeitos submetidos a prostatectomia radical / Postoperative recovery is a complex event that comprehends the resumption of daily activities and improvement of the physical, emotional and psychological states of the patients, which were altered as consequences of the surgical treatment. However, the determination of the moment in which the surgical recovery has occurred requires rigorous medical supervision of the patients. The Quality of recovery -40item (QoR-40) questionnaire enables an evaluation of the postoperative recovery in physical, emotional, social and psychological dimensions. Therefore, it can be an important tool for such supervision. The Qor-40 has 40 items with Likert scale answers and its total score varies from 40 to 200, in which the results are increased in accordance with the quality of postoperative recovery. It\'s a methodological study that aims to validate the Brazilian version of the QoR-40 questionnaire to be used with patients who have undergone radical prostatectomy. The questionnaire was answered by a sampling of 200 radical prostatectomized patients in four distinct moments: pre- and postoperative, first and second follow-up appointments. A semantic analysis of the questionnaire\'s items was performed, in a sampling independent of the validation sampling, to investigate the comprehension and relevance of each item. For the convergent construct validity, an investigation was performed, concerning the Pearson correlation between the QoR-40 measure and the measures of the constructs related to the domains of the quality of life questionnaire (SF-36v2®) as well as the measure of the visual analogue scale for postoperative recovery (VAS postoperative recovery). The discriminant validity was investigated by means of known groups, through the Mann-Whitney test, considering the QoR-40 measure in the groups of patients with a nursing diagnosis of Retarded postoperative recovery, with urinary incontinence and erectile dysfunction. The reliability was investigated by means of the internal consistency, considering Cronbach\'s alpha and inter-item/item-total correlations. Responsivity was investigated by means of linear regression with mixed effects and analysis of the standardized response mean (SRM). The semantic analysis, performed with 24 people, has resulted in discreet alterations in the wording of items 6, 19 and 23 in a manner that has accomplished their understanding, as identified in the pretest. In the convergent construct validity, the correlations between the measures of the QoR-40 and the measures of SF-36v2® and VAS postoperative recovery domains were predominantly moderate (r=0.18 to 0.89); the discriminant construct validity has presented differences between patients with a nursing diagnosis of Retarded postoperative recovery, with urinary incontinence (p<0.01). The reliability, by means of internal consistency, has obtained satisfactory Conbach\'s alpha values (0.75 to 0.86) and predominantly moderate inter-item and item-total correlations (r= 0.02 to 0.64). The responsivity was adequate, with a mean of difference of the statistically significant measures (p<0.01) in the course of time and with SRM varying from 0.03 to 1.11. As a result, it can be concluded that the QoR-40 has adequate validity, reliability and responsivity, taking into consideration the data obtained in the study performed with patients who have undergone radical prostatectomy

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